<include file="Public:header" />
   		<div class="mainbox" style="width:800px;height:1300px;"><br/>
        	<h1>北京化工大学报案信息填写</h1>
            <br/><br/><br/>

        <form class="form-horizontal" action="{:U('Admin/Report/save')}" method="POST">
            
            <div class="form-group" style="margin-bottom:-18px;">
                <label for="inputEmail3" class="col-sm-2 control-label" ><span style="color:#F00">*</span>接案人:</label>
                <div class="col-sm-9">
                  <input type="text" class="form-control" id="inputEmail3" disabled value="{$staff['staff_name']}">
                </div>
            </div>

            <div class="form-group" style="height:40px;">
            <label for="inputEmail3" class="col-sm-2 control-label"><span style="color:#F00">*</span>报案人:</label>
            <div class="col-sm-9">
              <input type="text" class="form-control" id="inputEmail3" name="informant" >
            </div>
            </div>
            
            <div class="form-group" style="height:40px;">
             <label for="inputEmail3" class="col-sm-2 control-label"><span style="color:#F00">*</span>身份证号:</label>
            <div class="col-sm-9">
              <input type="text" class="form-control" id="inputEmail3" name="id_card">
            </div>
            </div>  
  
             <div class="form-group" >
            <label for="inputEmail3" class="col-sm-2 control-label"><span style="color:#F00">*</span>联系电话:</label>
            <div class="col-sm-9">
              <input type="text" class="form-control" id="inputEmail3" name="phone">
            </div>
            </div>
            
             <div class="form-group" >
            <label for="inputEmail3" class="col-sm-2 control-label"><span style="color:#F00">*</span>单位:</label>
            <div class="col-sm-9">
              <input type="text" class="form-control" id="inputEmail3" name="unit">
            </div>
            </div>
            
            
            <div class="form-group" >
            <label for="inputEmail3" class="col-sm-2 control-label"><span style="color:#F00">*</span>住址:</label>
            <div class="col-sm-9">
              <input type="text" class="form-control" id="inputEmail3" name="address">
            </div>
            </div>

            <div class="form-group" >
            <label for="inputEmail3" class="col-sm-2 control-label"><span style="color:#F00">*</span>案发地点:</label>
            <div class="col-sm-9">
              <input type="text" class="form-control" id="inputEmail3" name="happen_place">
            </div>
            </div>
                
            <div class="form-group" style="line-height:55px;">

            <label for="inputEmail3" class="col-sm-2 control-label"><span style="color:#F00">*</span>报案时间:
            </label>
                <div class="col-sm-3" style="margin-left:19px;margin-top:18px;" >
                    <input type="text" value="{$now}" name="report_time"  onfocus="WdatePicker({ dateFmt:'yyyy-MM-dd HH:mm:ss' })" style="width:auto;">
                </div>
          </div>
          
          
          <div class="form-group" style="line-height:55px;">
            <label for="inputEmail3" class="col-sm-2 control-label"><span style="color:#F00">*</span>案发时间:</label>
              <div class="col-sm-3" style="margin-left:19px;margin-top:18px;" >
                  <span>
                     <input type="text" value="{$now}" name="happen_stime" placeholder="开始时间" onfocus="WdatePicker({ dateFmt:'yyyy-MM-dd HH:mm:ss' })" style="width:auto;">
                      至
                      <input type="text" value="{$now}" name="happen_etime" placeholder="结束时间" onfocus="WdatePicker({ dateFmt:'yyyy-MM-dd HH:mm:ss' })" style="width:auto;">
                  </span>

              </div>

        </div>
            <div class="form-group" >
            <label for="inputEmail3" class="col-sm-2 control-label">案发经过:</label>
            <div class="col-sm-9">
              
              <textarea class="form-control" rows="3" style="width:550px;height:150px;margin-left:0px;" name="happen_content"></textarea>
            </div>
            </div>
            
            <div class="form-group" >
            <label for="inputEmail3" class="col-sm-2 control-label">损失情况，失物名称及特征，估计价值</label>
            <div class="col-sm-9">
              
              <textarea class="form-control" rows="3" style="width:550px;height:150px;margin-left:0px;" name="extern"></textarea>
            </div>
            </div>
            <br/>
             <button type="submit" class="btn btn-info btn-lg" style="margin-left:50px;" onclick="window.location.href=''">
             	<span class="glyphicon glyphicon-ok-sign" aria-hidden="true"></span> &nbsp;&nbsp;保存记录&nbsp;&nbsp;&nbsp;
             </button>
       
             <!--<button type="button" class="btn btn-success btn-lg" style="margin-left:50px;" onclick="window.location.href='g_report_apply.html'">-->
             	<!--<span class="glyphicon glyphicon-facetime-video" aria-hidden="true"></span> &nbsp;&nbsp;申请查看录像&nbsp;&nbsp;&nbsp;-->
             <!--</button>-->
           
             </form>
           
        
        
    	</div>
    </div>
</div> 

    		<!-- 2 加载jQuery库，同时加载该库必须在加载bootstrap.min.js之前  -->
			<script src="http://cdn.bootcss.com/jquery/1.11.3/jquery.min.js"></script>
            <!-- 3 加载bootstrap核心 -->
            <script src="<?php echo JS_URL ;?>bootstrap.min.js"></script>
</body>
</html>
